Endocrinology, Diabetes and Metabolism最新文献_第5页

Predictors of Post-Bariatric Surgery Hypoglycemia: A Multicenter Retrospective Cohort Study 减肥手术后低血糖的预测因素：一项多中心回顾性队列研究。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-11-09 DOI: 10.1002/edm2.70123

Mansour Bahardoust, Ali Ranjbarpazuki, Mohammadsadra Shamohammadi, Alla Mousavi, Danyal Yarahmadi, Meisam Haghmoradi, Babak Goodarzy, Armaghan Abbasi Garavand, Adnan Tizmaghz

Introduction

Post-bariatric hypoglycemia (PBH) is a recognized complication that typically occurs within 1–3 years after bariatric surgery. We aimed to identify predictors of PBH in a large multicenter cohort.

Materials and Methods

This retrospective, multicenter cohort study reviewed the medical records of 952 obese patients (body mass index (BMI) ≥ 35 kg/m²) who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2020 and 2024 at three medical centers. PBH in a patient after bariatric surgery was defined as biochemically confirmed hypoglycemia less than 3.0 mmol/L (54 mg/dL) with typical symptoms of hypoglycemia, according to Whipple's triad. PBH incidence was evaluated at 12, 15, and 18 months postoperatively. Multivariable logistic regression was used to estimate adjusted associations with PBH after 12 months.

Results

Cumulative PBH incidence was 25.9% at 12 months, 29.3% at 15 months, and 35.4% at 18 months. Factors associated with increased PBH risk included female sex (Odds Ratio (OR): 1.91, 95% Confidence Interval: 1.11–2.71), high school graduate (OR: 1.61, 95% CI: 1.10–2.11), vitamin B1/B12 deficiency (OR: 1.45, 95% CI: 1.04–1.85), and RYGB surgery (OR: 1.81, 95% CI: 1.11–2.51). Protective factors included having type 2 diabetes (OR: 0.75, 95% CI: 0.55–0.96), higher baseline HbA1c (OR: 0.97, 95% CI: 0.95–0.99), and longer diabetes duration (OR: 0.95, 95% CI: 0.91–0.99).

Conclusion

PBH is a challenging complication after bariatric surgery. Our findings underscore the importance of considering metabolic, sociodemographic, and nutritional factors in assessing the risk of PBH.

简介：减肥后低血糖（PBH）是一种公认的并发症，通常发生在减肥手术后1-3年内。我们的目的是在一个大型多中心队列中确定PBH的预测因素。材料和方法：这项回顾性、多中心队列研究回顾了2020年至2024年间在三个医疗中心接受Roux-en-Y胃旁路术（RYGB）或袖式胃切除术（SG）的952例肥胖患者（体重指数(BMI)≥35 kg/m2）的医疗记录。根据Whipple's triad，减肥手术后患者的PBH被定义为生化证实的低血糖低于3.0 mmol/L (54 mg/dL)，伴有低血糖的典型症状。分别于术后12、15和18个月评估PBH的发生率。采用多变量logistic回归估计12个月后与PBH的校正相关性。结果：12个月时PBH的累积发病率为25.9%，15个月时为29.3%，18个月时为35.4%。与PBH风险增加相关的因素包括女性（优势比（OR）： 1.91, 95%置信区间：1.11-2.71）、高中毕业生（OR: 1.61, 95% CI: 1.10-2.11）、维生素B1/B12缺乏（OR: 1.45, 95% CI: 1.04-1.85）和RYGB手术（OR: 1.81, 95% CI: 1.11-2.51）。保护因素包括患有2型糖尿病（OR: 0.75, 95% CI: 0.55-0.96）、较高的基线HbA1c （OR: 0.97, 95% CI: 0.95-0.99）和较长的糖尿病病程（OR: 0.95, 95% CI: 0.91-0.99）。结论：PBH是减肥手术后一个具有挑战性的并发症。我们的研究结果强调了在评估PBH风险时考虑代谢、社会人口学和营养因素的重要性。

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引用次数: 0

Low Ankle-Brachial Index Is Associated With Albuminuria and Diabetic Kidney Disease in Type 2 Diabetes; A Cross Sectional Study 低踝肱指数与2型糖尿病蛋白尿和糖尿病肾病相关横断面研究

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-11-07 DOI: 10.1002/edm2.70115

Maryam Hedayati Moshkele, Saeed Mirmoosavi, Mohammad Taghi Najafi, Sahar Karimpour, Alireza Esteghamati, Manouchehr Nakhjavani, Soghra Rabizadeh

Background

Micro- and macrovascular complications of type 2 diabetes, including diabetic kidney disease (DKD) and peripheral artery disease (PAD), impose a significant burden on patients and healthcare systems. Diabetes is associated with a twofold higher risk of PAD. No studies from the Middle East have examined the relationship between PAD and DKD. Given the shared vascular pathology of DKD and PAD, this study investigated the association between a low ankle-brachial index (ABI) and albuminuria/DKD.

Method

This analytical cross-sectional study included patients diagnosed with diabetes per ADA criteria. ABI was measured using a four-channel automated oscillometric sphygmomanometer after 30 min of rest. DKD was defined as albuminuria [urinary albumin > 30 mg/g cr] and/or eGFR < 60 mL/min/1.73 m². Binary logistic regression assessed the association between ABI and both albuminuria and DKD, adjusting for confounders.

Results

Among 151 patients, 48% had PAD in at least one limb defined by ABI ≤ 0.9. ABI ≤ 0.9 was associated with albuminuria (OR = 2.32, 95% CI: 1.15–4.7, p = 0.01), which remained significant after adjustment for age, sex, hypertension, and coronary artery disease (CAD) (OR = 2.97, 95% CI: 1.28–6.8, p = 0.02). Similarly, ABI ≤ 0.9 increased the odds of DKD (OR = 2.7, 95% CI: 1.39–5.2, p = 0.003), and after adjustment, the association remained significant (OR = 2.99, 95% CI: 1.05–8.4, p = 0.04). ABI < 0.8 further increased the risk of DKD (OR = 7.5, 95% CI: 1.9–29, p = 0.003).

Conclusion

A reduced ABI (< 0.9) is independently associated with both albuminuria and DKD in type 2 diabetes, with a stronger association at ABI < 0.8. These findings highlight the potential role of ABI as a simple, non-invasive, and accessible screening tool for identifying patients at increased risk of DKD.

2型糖尿病的微血管和大血管并发症，包括糖尿病肾病（DKD）和外周动脉疾病（PAD），给患者和医疗保健系统带来了沉重的负担。糖尿病与患PAD的风险增加两倍有关。没有来自中东的研究检查PAD和DKD之间的关系。鉴于DKD和PAD具有共同的血管病理，本研究探讨了低踝肱指数（ABI）与蛋白尿/DKD之间的关系。方法本分析性横断面研究纳入了根据ADA标准诊断为糖尿病的患者。休息30分钟后，使用四通道自动振荡血压计测量ABI。DKD定义为尿白蛋白[尿白蛋白30mg /g / cr]和/或eGFR 60ml /min/1.73 m2。二元逻辑回归评估ABI与蛋白尿和DKD之间的关系，调整混杂因素。结果151例患者中，48%的患者至少有一条肢体存在PAD （ABI≤0.9）。ABI≤0.9与蛋白尿相关（OR = 2.32, 95% CI: 1.15-4.7, p = 0.01），在调整年龄、性别、高血压和冠状动脉疾病（CAD）后（OR = 2.97, 95% CI: 1.28-6.8, p = 0.02），这一相关性仍然显著。同样，ABI≤0.9增加DKD的几率（OR = 2.7, 95% CI: 1.39 ~ 5.2, p = 0.003），调整后相关性仍然显著（OR = 2.99, 95% CI: 1.05 ~ 8.4, p = 0.04）。ABI <； 0.8进一步增加DKD的风险（OR = 7.5, 95% CI: 1.9-29, p = 0.003）。结论2型糖尿病患者ABI降低（< 0.9）与蛋白尿和DKD均独立相关，ABI降低（< 0.8）时相关性更强。这些发现强调了ABI作为一种简单、无创、易获得的筛查工具，在识别DKD风险增加的患者方面的潜在作用。

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引用次数: 0

Obstructive Sleep Apnoea and Risk of Fragility Fracture in Patients With Type 2 Diabetes: A Population-Based Retrospective Cohort Study 阻塞性睡眠呼吸暂停和2型糖尿病患者脆性骨折的风险：一项基于人群的回顾性队列研究

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-11-07 DOI: 10.1002/edm2.70100

Esraa A. Makhdom, Anuradhaa Subramanian, Krishnarajah Nirantharakumar, Nicola J. Adderley, Abd A. Tahrani

Objective

This study examines the risk of fragility fractures in patients with type 2 diabetes (T2D) who have obstructive sleep apnoea (OSA) compared to those without OSA.

Method

This retrospective cohort study uses UK primary care data from 2000 to 2022. T2D patients without prior fragility fractures were included. Patients with OSA were matched with up to 4 non-OSA patients based on age, sex, BMI and T2D duration. Two cohorts were analysed based on whether OSA was diagnosed before (cohort 1) or after (cohort 2) the T2D diagnosis. Hazard ratios were calculated using a Cox proportional hazards model.

Results

Cohort 1 included 19,795 patients with OSA and 64,124 without OSA. Cohort 2 included 21,769 patients with OSA and 66,350 without OSA. OSA was associated with an increased risk of incident fragility fractures in both cohorts [aHR (95% CI): 1.12 (1.00–1.25); p = 0.04, and 1.15 (1.05–1.26; p = 0.002), respectively]. The point estimates of the subgroup analysis by age and gender of cohort 1 suggest an association between OSA and the risk of fractures in men and in those above 50 years old. In cohort 2, the subgroup analysis point estimate suggests an association between OSA and fragility fractures in men and women and those above and below 50 years old.

Conclusion

OSA is associated with an increased fragility fracture risk in T2D patients. Further studies are needed to determine if treating OSA reduces this risk. Clinicians should consider bone health and fracture risk, particularly for older patients.

目的研究阻塞性睡眠呼吸暂停（OSA）的2型糖尿病（T2D）患者与非OSA患者脆性骨折的风险。方法回顾性队列研究使用2000年至2022年英国初级保健数据。未发生脆性骨折的T2D患者纳入研究。根据年龄、性别、BMI和T2D持续时间，将OSA患者与最多4名非OSA患者进行匹配。根据T2D诊断前（队列1）或后（队列2）是否诊断出OSA，对两个队列进行分析。采用Cox比例风险模型计算风险比。结果队列1包括19795例OSA患者和64124例非OSA患者。队列2包括21769名OSA患者和66350名非OSA患者。OSA与两组患者发生脆性骨折的风险增加有关[aHR (95% CI): 1.12 (1.00-1.25)；p = 0.04和1.15 (1.05 - -1.26;p = 0.002),分别)。队列1按年龄和性别进行的亚组分析的点估计表明，OSA与男性和50岁以上人群骨折风险之间存在关联。在队列2中，亚组分析点估计表明OSA与脆性骨折在男性和女性以及50岁以上和以下人群中存在关联。结论阻塞性睡眠呼吸暂停与T2D患者脆性骨折风险增加有关。需要进一步的研究来确定治疗阻塞性睡眠呼吸暂停是否能降低这种风险。临床医生应考虑骨骼健康和骨折风险，特别是老年患者。

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引用次数: 0

Once-Weekly Insulin Efsitora Alfa Versus Once Daily Insulin in Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis 2型糖尿病患者每周一次胰岛素Efsitora与每天一次胰岛素：系统回顾和荟萃分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-28 DOI: 10.1002/edm2.70126

Harris Mehmood, Moaz Alowami, Thel Su Hlaing, Khant Nyi Zaya, Yousrah Uraiby, Ahmed Muaaz Alam, Abubakr Adala, Osama Ikram, Syed Faisal Ali, Muzammil Farhan, Eeshal Zulfiqar, Mushood Ahmed, Raheel Ahmed, Ammara Naeem

Background

Once-daily basal insulin is widely used in the management of type 2 diabetes, but poor adherence to daily injections often impairs glycaemic control. Once-weekly efsitora alfa may overcome these limitations, but pooled data assessing its comparative efficacy and safety remain limited.

Methods

PubMed/MEDLINE, Google Scholar, and the Cochrane Library were searched up to July 2025 for RCTs comparing once-weekly efsitora with once daily insulin in adults with T2D. Weighted mean differences (MDs), odds ratios (ORs), and risk ratios (RRs) were pooled using a random-effects model, and results were reported with 95% confidence intervals.

Results

Six RCTs comprising 3967 participants were included. There were no significant differences between once-weekly efsitora and daily insulin in change in HbA1c (MD –0.04; 95% CI –0.10 to 0.02; p = 0.15), change in fasting plasma glucose (MD 1.94 mg/dL; 95% CI –2.98 to 6.86; p = 0.44), proportion of patients achieving HbA1c < 7%, change in body weight, or time below range. Efsitora was associated with an increase in time in range (MD 0.80 percentage points; 95% CI 0.09 to 1.52; p = 0.03) and a reduction in time above range (MD –1.45 percentage points; 95% CI –2.87 to −0.02; p = 0.05). The risk of treatment-emergent adverse events (TEAEs) was higher with efsitora (RR 1.13; 95% CI 1.05 to 1.20; p = 0.0004), whereas serious adverse events, hypersensitivity reactions, injection-site reactions, and hypoglycaemia events were comparable between the two groups.

Conclusion

Once-weekly efsitora provides comparable glycaemic control and improved time-in-range compared to daily insulin, although with a higher rate of TEAEs.

背景：每日一次的基础胰岛素被广泛应用于2型糖尿病的治疗，但每日注射的依从性差往往会损害血糖控制。每周一次的efsitora可以克服这些限制，但评估其相对疗效和安全性的汇总数据仍然有限。方法：检索PubMed/MEDLINE、谷歌Scholar和Cochrane Library截至2025年7月的rct，比较每周一次的胰岛素注射与每天一次的胰岛素注射对成年T2D患者的影响。加权平均差异（MDs）、优势比（ORs）和风险比（rr）采用随机效应模型合并，结果以95%置信区间报告。结果：纳入6项随机对照试验，共3967名受试者。在HbA1c变化（MD为-0.04；95% CI为-0.10 ~ 0.02;p = 0.15）、空腹血糖变化（MD为1.94 mg/dL； 95% CI为-2.98 ~ 6.86;p = 0.44）、达到HbA1c的患者比例方面，每周一次efsitora和每日胰岛素治疗之间无显著差异。结论：与每日胰岛素治疗相比，每周一次efsitora提供了相当的血糖控制和改善的时间范围，尽管teae发生率更高。

{"title":"Once-Weekly Insulin Efsitora Alfa Versus Once Daily Insulin in Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis","authors":"Harris Mehmood, Moaz Alowami, Thel Su Hlaing, Khant Nyi Zaya, Yousrah Uraiby, Ahmed Muaaz Alam, Abubakr Adala, Osama Ikram, Syed Faisal Ali, Muzammil Farhan, Eeshal Zulfiqar, Mushood Ahmed, Raheel Ahmed, Ammara Naeem","doi":"10.1002/edm2.70126","DOIUrl":"10.1002/edm2.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Once-daily basal insulin is widely used in the management of type 2 diabetes, but poor adherence to daily injections often impairs glycaemic control. Once-weekly efsitora alfa may overcome these limitations, but pooled data assessing its comparative efficacy and safety remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed/MEDLINE, Google Scholar, and the Cochrane Library were searched up to July 2025 for RCTs comparing once-weekly efsitora with once daily insulin in adults with T2D. Weighted mean differences (MDs), odds ratios (ORs), and risk ratios (RRs) were pooled using a random-effects model, and results were reported with 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six RCTs comprising 3967 participants were included. There were no significant differences between once-weekly efsitora and daily insulin in change in HbA1c (MD –0.04; 95% CI –0.10 to 0.02; <i>p</i> = 0.15), change in fasting plasma glucose (MD 1.94 mg/dL; 95% CI –2.98 to 6.86; <i>p</i> = 0.44), proportion of patients achieving HbA1c < 7%, change in body weight, or time below range. Efsitora was associated with an increase in time in range (MD 0.80 percentage points; 95% CI 0.09 to 1.52; <i>p</i> = 0.03) and a reduction in time above range (MD –1.45 percentage points; 95% CI –2.87 to −0.02; <i>p</i> = 0.05). The risk of treatment-emergent adverse events (TEAEs) was higher with efsitora (RR 1.13; 95% CI 1.05 to 1.20; <i>p</i> = 0.0004), whereas serious adverse events, hypersensitivity reactions, injection-site reactions, and hypoglycaemia events were comparable between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Once-weekly efsitora provides comparable glycaemic control and improved time-in-range compared to daily insulin, although with a higher rate of TEAEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and Safety of iLet Bionic Pancreas in Patients With Type 1 Diabetes Mellitus: A Systematic Review and Meta Analysis iLet仿生胰腺治疗1型糖尿病的疗效和安全性：系统评价和Meta分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-28 DOI: 10.1002/edm2.70127

Sunny Kumar, F. N. U. Aakash, Nisha Kumari, Chandar Kanta Lohana, Alina Abbas, F. N. U. Gyaneshwari, Raveena Kumari, F. N. U. Eman, Reena Bai, Saifullah Syed, Mahveer Maheshwari, Rahul Rai, Faiqa Iqbal, Mohammad Jawwad, Hira Riaz

Background

This systematic review and meta-analysis evaluated the efficacy and safety of the iLet bionic pancreas (iLet BP), a novel automated insulin delivery (AID) system, in managing type 1 diabetes. Unlike conventional AID systems, which require user input for insulin dosing, the iLet BP autonomously determines insulin delivery based solely on body weight. The study synthesized data from five randomized controlled trials (RCTs), comprising a total of 1130 patients, comparing iLet BP with standard care (SC).

Outcomes Assessed

Primary outcomes included changes in HbA1c, mean glucose levels, and time in target glucose range (70–180 mg/dL), measured via continuous glucose monitoring (CGM). Secondary outcomes assessed adverse events and hypoglycaemia.

Key Findings

Results demonstrated that the iLet BP significantly improved glycaemic control. The pooled analysis showed a standardised mean difference (SMD) in HbA1c of −0.50 [−0.63, −0.38] and in mean glucose levels of −0.36 [−0.50, −0.21] favouring iLet BP. Time in target glucose range was significantly higher with iLet BP (SMD: 0.58 [0.43, 0.73]). However, the odds of adverse events were notably higher in the iLet BP group (OR: 15.48 [8.07, 29.70]), while the risk of hypoglycaemia (OR: 2.22 [0.83, 5.94]) was not statistically significant.

Conclusion

In conclusion, the iLet BP shows strong potential in improving glycaemic outcomes in patients with type 1 diabetes. However, concerns remain regarding its safety profile, particularly related to adverse events. Further large-scale, high-quality studies are needed to confirm its effectiveness and ensure broader clinical applicability.

背景：本系统综述和荟萃分析评估了iLet仿生胰腺（iLet BP）治疗1型糖尿病的有效性和安全性，iLet BP是一种新型的自动胰岛素输送（AID）系统。与需要用户输入胰岛素剂量的传统AID系统不同，iLet BP仅根据体重自主决定胰岛素的剂量。该研究综合了5项随机对照试验（RCTs）的数据，共包括1130名患者，比较了iLet BP和标准治疗（SC）。评估的结局：主要结局包括HbA1c、平均血糖水平的变化，以及通过连续血糖监测（CGM）测量的目标血糖范围（70-180 mg/dL）的时间。次要结局评估不良事件和低血糖。主要发现：结果表明，iLet BP显著改善血糖控制。合并分析显示，HbA1c的标准化平均差异（SMD）为-0.50[-0.63,-0.38]，平均葡萄糖水平为-0.36[-0.50,-0.21]，有利于iLet BP。在目标血糖范围内停留的时间明显高于iLet BP （SMD: 0.58[0.43, 0.73]）。然而，iLet BP组不良事件发生的几率明显更高（OR: 15.48[8.07, 29.70]），而低血糖发生的风险（OR: 2.22[0.83, 5.94]）无统计学意义。结论：总之，iLet BP在改善1型糖尿病患者的血糖结局方面显示出强大的潜力。然而，对其安全性的担忧仍然存在，特别是与不良事件有关。需要进一步大规模、高质量的研究来证实其有效性并确保更广泛的临床适用性。

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引用次数: 0

The Effect of Yacon Consumption on Glycemic Control and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomised Controlled Trials 食用雪莲果对血糖控制和血脂的影响：随机对照试验的系统回顾和荟萃分析。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-28 DOI: 10.1002/edm2.70121

Maryam Nilghaz, Fatemeh Sheikhhossein, Mahnoush Mehrzad Samarin, Mohammad Reza Amini, Mahsa Elahikhah, Moharam Jalalzadeh, Maryam Khakbaz, Negin Lohrasbi, Sajjad Etesamnia, Fatemeh Torkizadeh, Azita Hekmatdoost

Background

Recent human studies have indicated the beneficial effects of yacon on diabetes and metabolic syndrome; however, no meta-analysis has investigated the effects of yacon on glycemic control and lipid profiles.

Methods

Searches were conducted in five databases—PubMed, Web of Science, Scopus, Google Scholar, Cochrane Library—and relevant randomised controlled trials (RCTs) until June 2024. The random-effects model was employed to compute the effect size, thereafter represented as a weighted mean difference (WMD) and a 95% confidence interval (CI). This study's registration number in PROSPERO is CRD420251028504.

Results

This study integrated seven RCTs with 239 participants. The results demonstrated that yacon consumption had no statistically significant effects on fasting blood sugar (FBS, p = 0.33), insulin levels (p = 0.76), homeostasis model assessment for insulin resistance (HOMA-IR, p = 0.42), total cholesterol (TC, p = 0.17), low-density lipoprotein (LDL, p = 0.12), high-density lipoprotein (HDL, p = 0.42), or triglycerides (TG, p = 0.75). However, subgroup studies indicated that yacon consumption reduced FBS levels over an exceeding 8-week duration in both sexes and in persons over 40. Furthermore, yacon intake resulted in a decrease in LDL-cholesterol levels for more than 8 weeks, particularly in women and individuals over 40. Additionally, it led to a decrease in LDL-cholesterol levels among women and individuals over 40 who consumed yacon for more than 8 weeks, and HDL-cholesterol levels increased in those aged 40 and above.

Conclusion

Overall, this meta-analysis indicates that yacon use in adults does not lead to significant improvements in lipid profiles or glycemic parameters.

背景：最近的人体研究表明，雪莲果对糖尿病和代谢综合征有有益的作用；然而，没有荟萃分析调查雪莲果对血糖控制和血脂的影响。方法：截至2024年6月，在pubmed、Web of Science、Scopus、b谷歌Scholar、Cochrane library等5个数据库和相关随机对照试验（RCTs）中进行检索。采用随机效应模型计算效应大小，然后用加权平均差（WMD）和95%置信区间（CI）表示。本研究在PROSPERO的注册号为CRD420251028504。结果：本研究纳入7项随机对照试验，239名受试者。结果表明，食用雪雪果对空腹血糖（FBS, p = 0.33）、胰岛素水平（p = 0.76）、胰岛素抵抗稳态模型评估（HOMA-IR, p = 0.42）、总胆固醇（TC, p = 0.17）、低密度脂蛋白（LDL, p = 0.12）、高密度脂蛋白（HDL, p = 0.42）或甘油三酯（TG, p = 0.75）均无统计学意义。然而，亚组研究表明，在超过8周的时间内，无论是男女还是40岁以上的人，食用雪茄烟都会降低FBS水平。此外，食用雪糕可使低密度脂蛋白胆固醇水平下降超过8周，尤其是女性和40岁以上的人。此外，食用雪莲果8周以上的女性和40岁以上的人的低密度脂蛋白胆固醇水平下降，而40岁及以上的人的高密度脂蛋白胆固醇水平上升。结论：总的来说，这项荟萃分析表明，成人使用雪莲果不会导致血脂或血糖参数的显着改善。

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引用次数: 0

The Effect of Kefir Consumption on Blood Pressure and C-Reactive Protein: A Systematic Review and Meta-Analysis of Randomised Controlled Trials 饮用开菲尔对血压和c反应蛋白的影响：随机对照试验的系统回顾和荟萃分析。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-26 DOI: 10.1002/edm2.70124

Elaheh Rashidbeygi, Mahnoush Mehrzad Samarin, Fatemeh Sheikhhossein, Amir Hossein Khalilkhaneh, Masoomeh Gholizadeh, Negin Lohrasbi, Amin Abbasi, Hadi Bazyar, Gholamreza Askari, Mohammad Reza Amini

Background

Kefir, a traditional fermented milk beverage, has been increasingly promoted for its various health benefits. This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to assess the effects of kefir on blood pressure and C-reactive protein (CRP) levels.

Methods

A literature search was conducted using databases such as ISI Web of Science, Scopus and PubMed for articles published until January 2025, with no restrictions. A random-effects meta-analysis was conducted for all key outcome measures. The inverse-variance weighted mean difference (WMD) was calculated with a 95% confidence interval (CI).

Results

A total of seven RCTs, comprising 385 subjects, were included in the meta-analysis. We involved RCTs conducted on adult participants (over 18 years old). These studies generally administered kefir for at least 2 weeks and compared the outcomes to those in the control group. The findings showed that kefir consumption had no significant impact on systolic blood pressure (SBP) (WMD: −1.76 mmHg; 95% CI: −5.21, 1.69; p = 0.317), diastolic blood pressure (DBP) (WMD: −1.19 mmHg; 95% CI: −3.40, 1.03; p = 0.295) or CRP levels (WMD: −0.17 mg/L; 95% CI: −0.84, 0.49; p = 0.609) compared to those who did not consume kefir. However, subgroup analysis indicated that CRP levels significantly decreased with longer durations of kefir consumption (≥ 8 weeks).

Conclusion

Kefir consumption in adults did not result in significant reductions in systolic or diastolic blood pressure or CRP levels. Nonetheless, there is some evidence that long-term kefir consumption may improve CRP levels over time.

背景：开菲尔是一种传统的发酵乳饮料，因其多种健康益处而受到越来越多的推广。本系统综述和荟萃分析的随机对照试验（rct）旨在评估开菲尔对血压和c反应蛋白（CRP）水平的影响。方法：使用ISI Web of Science、Scopus、PubMed等数据库检索2025年1月前发表的无限制文章。对所有关键结局指标进行随机效应荟萃分析。以95%置信区间（CI）计算反方差加权平均差（WMD）。结果：meta分析共纳入7项rct，共385名受试者。我们纳入了对成年参与者（18岁以上）进行的随机对照试验。这些研究通常给予开非尔至少2周，并将结果与对照组的结果进行比较。研究结果显示，与不喝开非尔的人相比，喝开非尔对收缩压（SBP）（WMD: -1.76 mmHg; 95% CI: -5.21, 1.69; p = 0.317）、舒张压（DBP）（WMD: -1.19 mmHg; 95% CI: -3.40, 1.03; p = 0.295）或CRP水平（WMD: -0.17 mg/L; 95% CI: -0.84, 0.49; p = 0.609）没有显著影响。然而，亚组分析表明，CRP水平随着开菲尔饮用时间的延长（≥8周）而显著降低。结论：成人饮用开非尔不会显著降低收缩压或舒张压或CRP水平。尽管如此，有证据表明长期饮用开菲尔可能会随着时间的推移提高CRP水平。

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引用次数: 0

Vitamin D for Painful Diabetic Neuropathy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials 维生素D治疗疼痛性糖尿病神经病变：随机对照试验的系统回顾和荟萃分析。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-26 DOI: 10.1002/edm2.70118

Abraham Gilbody, Joseph Gilbody

Background

Painful diabetic neuropathy (PDN) is a common complication of type 1 and type 2 diabetes, causing substantial morbidity. Current treatments, including antidepressants and analgesics, are often only partially effective and may have significant side effects. Vitamin D deficiency affects around 60% of people with diabetes, making supplementation a low-toxicity, biologically plausible intervention. Observational studies suggest potential benefit, but robust evidence from randomised controlled trials (RCTs) is lacking.

Objective

To systematically review and synthesise RCT evidence on the effect of vitamin D supplementation on pain outcomes in PDN.

Methods

A systematic search was conducted in Medline, EMBASE, Web of Science, Cochrane Library, CINAHL, EBSCO and Google Scholar up to September 2025. Eligible studies were RCTs comparing vitamin D supplementation with placebo in adults with diabetes and PDN. The primary outcome was pain intensity measured with validated tools. A fixed-effects meta-analysis was performed, with results expressed as standardised mean differences (SMD). Risk of bias was assessed using the Cochrane RoB tool, and publication bias examined via Egger's funnel plot.

Results

Five studies met inclusion criteria; four (n = 320) were included in the meta-analysis. Pooled results showed a significant short-term reduction in pain with vitamin D versus placebo (SMD = −0.85; 95% CI: −1.07 to −0.62), with moderate heterogeneity (I² = 61.4%), equivalent to ~11 points on common pain scales. No studies reported medium- or long-term outcomes. Study quality varied, with concerns regarding allocation concealment and selective outcome reporting. Four trials were prospectively registered.

Conclusion

Vitamin D supplementation may reduce short-term pain in PDN, but evidence is limited by small sample sizes and methodological quality. Larger, rigorously designed RCTs with longer follow-up are needed before routine vitamin D testing or supplementation can be recommended for PDN in clinical practice.

背景：疼痛性糖尿病神经病变（PDN）是1型和2型糖尿病的常见并发症，发病率很高。目前的治疗方法，包括抗抑郁药和止痛药，往往只是部分有效，可能有明显的副作用。大约60%的糖尿病患者缺乏维生素D，因此补充维生素D是一种低毒性、生物学上合理的干预措施。观察性研究提示潜在的益处，但缺乏来自随机对照试验（RCTs）的有力证据。目的：系统回顾和综合维生素D补充对PDN患者疼痛结局影响的RCT证据。方法：系统检索Medline、EMBASE、Web of Science、Cochrane Library、CINAHL、EBSCO、谷歌Scholar等数据库，检索截止日期为2025年9月。符合条件的研究是比较维生素D补充剂与安慰剂在糖尿病和PDN成人患者中的作用的随机对照试验。主要结局是用有效的工具测量疼痛强度。进行固定效应荟萃分析，结果表示为标准化平均差异（SMD）。使用Cochrane RoB工具评估偏倚风险，通过Egger’s漏斗图检查发表偏倚。结果：5项研究符合纳入标准；4例（n = 320）纳入meta分析。综合结果显示，与安慰剂相比，维生素D在短期内显著减轻了疼痛（SMD = -0.85; 95% CI: -1.07至-0.62），具有中等异质性（I2 = 61.4%），相当于普通疼痛量表上的~11分。没有研究报告中期或长期结果。研究质量各不相同，涉及分配、隐瞒和选择性结果报告。4项试验前瞻性登记。结论：补充维生素D可以减轻PDN患者的短期疼痛，但由于样本量小和方法学质量问题，证据有限。在临床实践中推荐常规维生素D检测或补充之前，需要更大规模、更严格设计、随访时间更长的随机对照试验。

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引用次数: 0

Diabetes and Obesity Modify the Effect of Alcohol Consumption on Carbohydrate-Deficient Transferrin 糖尿病和肥胖改变了饮酒对碳水化合物缺乏的转铁蛋白的影响。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-23 DOI: 10.1002/edm2.70112

Tomás González-Vidal, Óscar Lado-Baleato, Fátima de la Osa, Manuela Alonso-Sampedro, Carmen Fernández-Merino, Juan Sánchez-Castro, Francisco Gude, Arturo González-Quintela

Aims

Serum levels of carbohydrate-deficient transferrin (CDT, the sum of its asialylated and disialylated glycoforms) are a commercial marker of alcohol abuse. Our aim was to investigate the potential influence of metabolic factors on serum CDT levels and the predictive value of transferrin glycoforms for the development of type 2 diabetes in a general adult population.

Materials and Methods

We measured serum CDT levels by capillary electrophoresis in 1516 individuals (median age 52 years; 55.3% women) randomly selected from the general adult population of a municipality.

Results

Insulin resistance and the associated body mass index and diabetes modified the effect of alcohol consumption on CDT levels; i.e., CDT in heavy drinkers was lower in individuals with obesity than in lean counterparts and was also lower in people with diabetes than in normoglycaemic individuals. The relative abundance of transferrin glycoforms was not significantly associated with the development of type 2 diabetes after a mean follow-up of 7.4 years.

Conclusions

There is an interaction between alcohol consumption and factors associated with insulin resistance in relation to transferrin sialylation. The sensitivity of CDT for detecting heavy alcohol consumption might be limited in people with obesity or diabetes.

目的：血清碳水化合物缺乏转铁蛋白（CDT，其asialated和didialated糖型的总和）水平是酒精滥用的商业标志。我们的目的是研究代谢因素对血清CDT水平的潜在影响，以及转铁蛋白糖型对普通成年人2型糖尿病发展的预测价值。材料和方法：我们通过毛细管电泳检测了1516个个体（中位年龄52岁，55.3%的女性）的血清CDT水平，这些个体是随机从一个城市的普通成年人中选择的。结果：胰岛素抵抗及相关体重指数和糖尿病改变了饮酒对CDT水平的影响；也就是说，酗酒者中肥胖人群的CDT低于瘦人群，糖尿病患者的CDT也低于血糖正常的人群。在平均7.4年的随访后，转铁蛋白糖型的相对丰度与2型糖尿病的发展无显著相关。结论：饮酒与胰岛素抵抗相关因素与转铁蛋白唾液酰化之间存在相互作用。CDT检测大量饮酒的敏感性可能在肥胖或糖尿病患者中受到限制。

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引用次数: 0

Are Bifidobacterium Species Key Players in the Progression of Type 1 Diabetes? A Systematic Review 双歧杆菌在1型糖尿病的进展中起关键作用吗？系统评价。

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2025-10-13 DOI: 10.1002/edm2.70120

Vanina Vergoz, Donna Jeong, Emma E. Hamilton-Williams

Background

Type 1 diabetes (T1D) frequently develops in childhood and is preceded by a non-symptomatic period of autoimmunity. Alterations in the gut microbiome are implicated in T1D pathogenesis. Bifidobacterium is a significant focus due to its positive health impacts, association with breastfeeding and presence in probiotics and infant milk-formulas. This systematic review aims to investigate Bifidobacterium's association with T1D across disease stages.

Methods

A comprehensive electronic search was conducted in MEDLINE, EMBASE and Web of Science, from 2011 to 2024. The search used a combination of medical subject headings and keywords related to Bifidobacterium. Studies included individuals at risk of T1D (pre-stage, stage 1 or 2 asymptomatic T1D) and with stage 3 symptomatic T1D while excluding T2D, clinical trials and animal studies.

Results

The search initially retrieved 1120 articles. Of these, 25 papers met the inclusion criteria, covering 4533 individuals (842 cases with or at-risk of T1D and 3691 healthy controls). The studies highlighted variability in Bifidobacterium abundance in T1D, with higher abundance found more often in at-risk asymptomatic individuals and lower abundance frequently found in those with established T1D.

Conclusion

These findings do not support loss of Bifidobacterium as a key factor in the early development of T1D. Further studies are needed to explore Bifidobacterium's role in T1D progression and management.

背景：1型糖尿病（T1D）经常发生在儿童时期，在此之前有一段无症状的自身免疫期。肠道微生物组的改变与T1D的发病机制有关。双歧杆菌由于其对健康的积极影响、与母乳喂养的关联以及益生菌和婴儿配方奶粉中的存在而成为一个重要的焦点。本系统综述旨在探讨双歧杆菌与T1D在疾病分期的关系。方法：对2011 - 2024年MEDLINE、EMBASE和Web of Science进行全面的电子检索。搜索使用了与双歧杆菌相关的医学主题标题和关键词的组合。研究包括有T1D风险的个体（前期、1期或2期无症状T1D）和3期有症状的T1D，但不包括T2D、临床试验和动物研究。结果：搜索最初检索到1120篇文章。其中，25篇论文符合纳入标准，涵盖4533人（842例T1D患者或高危患者，3691例健康对照）。这些研究强调了双歧杆菌在T1D中丰度的可变性，在有风险的无症状个体中发现的丰度较高，而在已确诊的T1D个体中发现的丰度较低。结论：这些发现不支持双歧杆菌缺失是T1D早期发展的关键因素。需要进一步研究双歧杆菌在T1D进展和管理中的作用。

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引用次数: 0